ABSA Surgical Assistant Certification 2026/2027 Exam
verified with correct answers plus rationales
Question 1
Before the surgical incision is made, the surgical assistant's primary responsibility is to
ensure that:
• A) The operative note has already been completed
• B) The correct patient, procedure, site, and required equipment have been
verified according to the surgical safety checklist
• C) The wound dressing has been applied
• D) The surgical team has taken a break
Correct Answer: B
Rationale: Verification through the surgical safety checklist is the critical safety measure
performed before incision to prevent wrong-site, wrong-patient, and wrong-procedure
surgeries. The "time out" is a formal process in which all team members must participate
just prior to incision .
Question 2
A patient is scheduled for surgery and has a do-not-resuscitate (DNR) order. What
should the surgical team do?
• A) Automatically suspend the DNR order during surgery
• B) Discuss the DNR order with the patient and/or family and determine the plan
for the perioperative period
• C) Ignore the DNR order
• D) Proceed with surgery without addressing the DNR
Correct Answer: B
Rationale: DNR orders should be discussed with the patient and/or family before
surgery to determine the plan for the perioperative period. Many facilities require a
"required reconsideration" of the DNR order before proceeding with surgery .
,Question 3
The surgical "time-out" is performed primarily to:
• A) Allow staff to prepare instruments
• B) Confirm patient identity, procedure, operative site, and team readiness before
incision
• C) Count surgical sponges
• D) Prepare postoperative orders
Correct Answer: B
Rationale: The time-out is a critical patient safety measure established by The Joint
Commission's Universal Protocol. It is performed immediately before incision to verify
the correct patient, procedure, and surgical site .
Question 4
Which medication should be reviewed preoperatively due to its effect on platelet
function?
• A) Metformin
• B) Aspirin
• C) Lisinopril
• D) Levothyroxine
Correct Answer: B
Rationale: Aspirin irreversibly inhibits platelet aggregation for the life of the platelet (7-
10 days). It should be reviewed preoperatively and typically withheld before elective
surgery to reduce bleeding risk .
Question 5
A patient has a history of malignant hyperthermia. Which preoperative action is most
important?
, • A) Administer dantrolene preoperatively
• B) Ensure a malignant hyperthermia cart is available
• C) Avoid all anesthetics
• D) Use only local anesthesia
Correct Answer: B
Rationale: For patients with a history of malignant hyperthermia, the surgical team must
ensure that a malignant hyperthermia cart (containing dantrolene) is available.
Triggering agents such as succinylcholine and volatile anesthetics should be avoided .
Question 6
A patient is scheduled for surgery and takes metformin for diabetes. What is the
appropriate preoperative management?
• A) Continue metformin as usual
• B) Hold metformin 24-48 hours before surgery
• C) Increase the metformin dose
• D) Discontinue metformin permanently
Correct Answer: B
Rationale: Metformin should typically be held 24-48 hours before surgery due to the
risk of lactic acidosis, particularly in patients with renal impairment or those undergoing
procedures with potential for hemodynamic instability .
Question 7
Which laboratory test is most important to evaluate before surgery in a patient with a
history of bleeding disorders?
• A) Complete blood count
• B) Prothrombin time (PT) and Partial thromboplastin time (PTT)
• C) Serum electrolytes
• D) Liver function tests
Correct Answer: B
, Rationale: PT and PTT assess the coagulation cascade and are essential for evaluating
bleeding risk in patients with known or suspected bleeding disorders .
Question 8
A patient with a history of heparin-induced thrombocytopenia (HIT) requires
anticoagulation for cardiopulmonary bypass. Which agent is most appropriate?
• A) Unfractionated heparin
• B) Direct thrombin inhibitor (e.g., bivalirudin or argatroban)
• C) Warfarin
• D) Enoxaparin
Correct Answer: B
Rationale: In patients with HIT, heparin and heparin derivatives must be avoided. Direct
thrombin inhibitors such as bivalirudin or argatroban are the agents of choice for
anticoagulation during cardiopulmonary bypass .
Question 9
A patient is scheduled for elective surgery and takes clopidogrel (Plavix). How many
days before surgery should this medication typically be stopped?
• A) 24 hours
• B) 5-7 days
• C) 10-14 days
• D) 2-3 days
Correct Answer: B
Rationale: Clopidogrel inhibits platelet aggregation and should typically be stopped 5-7
days before elective surgery to reduce bleeding risk .
verified with correct answers plus rationales
Question 1
Before the surgical incision is made, the surgical assistant's primary responsibility is to
ensure that:
• A) The operative note has already been completed
• B) The correct patient, procedure, site, and required equipment have been
verified according to the surgical safety checklist
• C) The wound dressing has been applied
• D) The surgical team has taken a break
Correct Answer: B
Rationale: Verification through the surgical safety checklist is the critical safety measure
performed before incision to prevent wrong-site, wrong-patient, and wrong-procedure
surgeries. The "time out" is a formal process in which all team members must participate
just prior to incision .
Question 2
A patient is scheduled for surgery and has a do-not-resuscitate (DNR) order. What
should the surgical team do?
• A) Automatically suspend the DNR order during surgery
• B) Discuss the DNR order with the patient and/or family and determine the plan
for the perioperative period
• C) Ignore the DNR order
• D) Proceed with surgery without addressing the DNR
Correct Answer: B
Rationale: DNR orders should be discussed with the patient and/or family before
surgery to determine the plan for the perioperative period. Many facilities require a
"required reconsideration" of the DNR order before proceeding with surgery .
,Question 3
The surgical "time-out" is performed primarily to:
• A) Allow staff to prepare instruments
• B) Confirm patient identity, procedure, operative site, and team readiness before
incision
• C) Count surgical sponges
• D) Prepare postoperative orders
Correct Answer: B
Rationale: The time-out is a critical patient safety measure established by The Joint
Commission's Universal Protocol. It is performed immediately before incision to verify
the correct patient, procedure, and surgical site .
Question 4
Which medication should be reviewed preoperatively due to its effect on platelet
function?
• A) Metformin
• B) Aspirin
• C) Lisinopril
• D) Levothyroxine
Correct Answer: B
Rationale: Aspirin irreversibly inhibits platelet aggregation for the life of the platelet (7-
10 days). It should be reviewed preoperatively and typically withheld before elective
surgery to reduce bleeding risk .
Question 5
A patient has a history of malignant hyperthermia. Which preoperative action is most
important?
, • A) Administer dantrolene preoperatively
• B) Ensure a malignant hyperthermia cart is available
• C) Avoid all anesthetics
• D) Use only local anesthesia
Correct Answer: B
Rationale: For patients with a history of malignant hyperthermia, the surgical team must
ensure that a malignant hyperthermia cart (containing dantrolene) is available.
Triggering agents such as succinylcholine and volatile anesthetics should be avoided .
Question 6
A patient is scheduled for surgery and takes metformin for diabetes. What is the
appropriate preoperative management?
• A) Continue metformin as usual
• B) Hold metformin 24-48 hours before surgery
• C) Increase the metformin dose
• D) Discontinue metformin permanently
Correct Answer: B
Rationale: Metformin should typically be held 24-48 hours before surgery due to the
risk of lactic acidosis, particularly in patients with renal impairment or those undergoing
procedures with potential for hemodynamic instability .
Question 7
Which laboratory test is most important to evaluate before surgery in a patient with a
history of bleeding disorders?
• A) Complete blood count
• B) Prothrombin time (PT) and Partial thromboplastin time (PTT)
• C) Serum electrolytes
• D) Liver function tests
Correct Answer: B
, Rationale: PT and PTT assess the coagulation cascade and are essential for evaluating
bleeding risk in patients with known or suspected bleeding disorders .
Question 8
A patient with a history of heparin-induced thrombocytopenia (HIT) requires
anticoagulation for cardiopulmonary bypass. Which agent is most appropriate?
• A) Unfractionated heparin
• B) Direct thrombin inhibitor (e.g., bivalirudin or argatroban)
• C) Warfarin
• D) Enoxaparin
Correct Answer: B
Rationale: In patients with HIT, heparin and heparin derivatives must be avoided. Direct
thrombin inhibitors such as bivalirudin or argatroban are the agents of choice for
anticoagulation during cardiopulmonary bypass .
Question 9
A patient is scheduled for elective surgery and takes clopidogrel (Plavix). How many
days before surgery should this medication typically be stopped?
• A) 24 hours
• B) 5-7 days
• C) 10-14 days
• D) 2-3 days
Correct Answer: B
Rationale: Clopidogrel inhibits platelet aggregation and should typically be stopped 5-7
days before elective surgery to reduce bleeding risk .
